Check the facts

Michigan Rep. Fred Upton exaggerated the impact of the Affordable Care Act when he claimed on Fox News on Dec. 11 that "perhaps as many as 80 to 90 million Americans with employer-based health care are going to lose their plans" by late this year.

Upton doesn't mean that those millions of Americans would no longer have health insurance through their employers. Instead, he's talking about health plans losing grandfathered status, which means they are exempted from some requirements of the Affordable Care Act because they existed before the law was enacted.

The claim, which other Republican lawmakers have repeated, is based on the premise that half of all employer plans were expected to lose grandfathered status in 2013, and more in 2014. But all employer plans are expected to eventually lose such status, and most workers are already on non-grandfathered policies - without incident. Many plans have been and will be merely modified without employees even knowing it.

It's true that some businesses will send workers to the state or federal exchanges, the most direct case of "losing" an employer plan - but there won't be 80 million of those workers.

The nonpartisan Congressional Budget Office has estimated that those with employer-based insurance would decline by a net 7 million in 2019 compared with what would have happened in the absence of the Affordable Care Act, with 11 million losing an offer of insurance from an employer, 3 million choosing to get their insurance from another source, and 7 million gaining insurance at work.

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Senate Majority Leader Harry Reid incorrectly claimed on CBS' "Face the Nation" on Jan. 5 that 9 million Americans "have health care that didn't have it before" because of the Affordable Care Act.

The 9 million figure includes three categoriesof Americans: 2.1 million who have selected plans on the federal or state insurance marketplaces, or exchanges; 3.9 million who were determined to be eligible for Medicaid and the Children's Health Insurance Program; and an estimated 3.1 million young adults under the age of 26 who were able to join their parents' policies as a result of the ACA.

But it's wrong to assume, as Reid does, that all of those people were previously uninsured.

Some may consider the inclusion of the 3.1 million young adults an attempt to puff up the numbers after a slow, glitch-filled and, by any standard, unsuccessful launch of the exchanges last fall. But this is the one estimate that's made up exclusively of those gaining insurance.

It's the other two categories that include folks who did have health coverage before, contrary to Reid's remarks.

The 2.1 million people who selected exchange plans include some who had insurance but switched to these marketplace plans, such as those whose insurers canceled specific plans or even pulled out of the individual insurance market altogether.

Then there's the Medicaid estimate. Some portion of that 3.9 million - a figure that comes from state reports - includes Americans who already had Medicaid or CHIP and are simply renewing, and it could include those who had insurance through another source and are now eligible for Medicaid.

CMS doesn't have such a breakdown on these Medicaid-eligible folks. The figure also includes those who were previously eligible for Medicaid (before the ACA) and are now signing up.

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Check the facts

Michigan Rep. Fred Upton exaggerated the impact of the Affordable Care Act when he claimed on Fox News on Dec. 11 that 'perhaps as many as 80 to 90 million Americans with employer-based health care